Progress 2019: GRHS focuses on regionalism

March 29-- Mar. 29--WEST BURLINGTON -- Great River Health System has expanded throughout southeast Iowa during the past several years, most recently opening a clinic in Keokuk, entering into an affiliation with Fort Madison Community Hospital and opening a a family planning clinic in Burlington.

But now, the health system is focusing on what it has.

"There is potential for growth, but the last thing I want to do is take my eye off of our partners now and focus too much on growth and let the ball drop," said Matt Wenzel, president and CEO of GRHS.

Wenzel took over at the helm of GRHS in January 2017, not long after it was announced that FMCH and GRHS were exploring an affiliation agreement. Bringing the two organizations together was a large undertaking on both hospitals' parts, but the partnership was made official Aug. 1.

"I came in just to try to listen and learn and develop relationships and understand the need of that community and Fort Madison Community Hospital, and I think that approach worked," Wenzel said.

The hospitals have retained their respective boards of directors, who worked together extensively throughout the affiliation process. They now also share a chief financial officer, Jason Alexander, who also is the CEO of FMCH.

"If I didn't think the relationship was going amazing, I wouldn't be asking their CEO to come up and be the health system's chief financial officer overseeing the books for both organizations," Wenzel said. "I think that's a great testament on how the partnership is working."

The partnership thus far already has resulted in savings of more than $1 million in costs for things such as health and medical malpractice insurance.

Wenzel said the savings on costs are especially important as GRHS is facing a $26 million loss this year, due in large part to reimbursements from managed care organizations. Wenzel said for every $1 that comes into the hospital, another $1.07 is being spent. FMCH is facing a $4 million loss.

"It's ways that we can work together better to increase revenue and decrease our costs to be able to serve our patients in southeast Iowa," Wenzel said.

Despite the loss, GRHS is in good enough financial standing that it can avoid making a "knee-jerk" reaction to the budget loss. Instead, it will bring in a consultant to help it examine how to combat the loss through making long-term adjustments. Wenzel likened the consultant's role to that of a dietician or personal trainer.

"You need to bring somebody in that does this across the country. We can look at best practices and see here's what another organization is doing, here's what you should consider, instead of us just going around making cuts, because that's the fad, yo-yo diet approach," he said.

Wenzel hopes the health system eventually will be able to set aside $1 to $3 million of its budget to put back into the community rather than just for operating income, but first it must address its deficit.

"If we can get operations humming -- and we will -- we can just be this multiplier of change for southeast Iowa," he said.

In addition to cost savings, the partnership also allows the two hospitals to continue making local decisions about healthcare.

"We felt we could make a bigger impact than doing it on our own or competing against each other," Wenzel said.

The result is an increased focus on regionalism, not just in services offered, but among hospital staff as well. Wenzel spoke of GRHS' Christmas party, which was attended by physicians and staff from Great River Medical Center, FMCH and Henry County Health Center, with which GRHS has had a management agreement for more than 10 years.

"When we're thinking about having medical staff meetings and get-togethers, we're starting to think about how do we connect Fort Madison, Henry County and Burlington," Wenzel said.

Whether GRMC and FMCH will share providers in the future will depend much on community needs and physicians' willingness to do so.

Fort Madison is far from GRHS' only area of focus.

The Keokuk Clinic, which is about four times larger than GRHS' previous Keokuk clinic, opened its doors Dec. 3. The clinic offers primary and urgent care as well as cardiology, digestive health, mental health, ophthalmology, orthopedics, podiatry, rheumatology, urology, women's health and physical therapy. It also has its own laboratory and X-ray, including 3D mammography and DEXA bone density scanning.

Wenzel said the 3D mammography has been an especially big draw for people living in the Keokuk community.

"We saw a need in that community where one of the big things that we did was 3D mammography," Wenzel said. "We've seen a really big uptick in women scheduling their mammograms at the new clinic."

There's also Family Planning of Southeast Iowa, a Title X family planning clinic that provides affordable reproductive health care for women and men. GRHS provided start-up money for the clinic, but it relies on funding from donors, fundraisers and grant reapplication.

Changes have been made at GRMC in West Burlington as well. Two cardiac catheterization laboratories have been updated in the Heart and Vascular Center, and, in response to a shortage of echocardiologists, the hospital has developed an accredited echocardiography training program from which two people have recently graduated.

Renovations on a number of patient rooms also have been remodeled with new cabinets, flooring and lighting, power window shades and sinks with touchless faucets.

A total of 21 new providers, including hospitalists, CRNAs, ARNPs and PAs have joined GRHS, as well, to meet community needs.

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